Which of the following would the nurse expect to find in a newborn who is developing sepsis? Select one:
Hyperglycemia and increased appetite.
Increased urinary output and spitting up mucous.
Wakefulness and ruddy appearance.
Temperature instability and lethargy.
The Correct Answer is D
Choice A Reason: Hyperglycemia and increased appetite. This is an incorrect answer that describes symptoms of diabetes mellitus, not sepsis. Diabetes mellitus is a chronic metabolic disorder where the body cannot produce or use insulin effectively, which results in high blood glucose levels and impaired glucose tolerance. Diabetes mellitus can affect newborns if the mother has pre-existing or gestational diabetes, which can cause macrosomia, hypoglycemia, or congenital anomalies.
Choice B Reason: Increased urinary output and spitting up mucous. This is an incorrect answer that indicates normal or benign conditions, not sepsis. Increased urinary output is a normal finding in newborns, as they eliminate the excess fluid that was accumulated during pregnancy. Spitting up mucous is a common occurrence in newborns, as they clear their airways of amniotic fluid or secretions.
Choice C Reason: Wakefulness and ruddy appearance. This is an incorrect answer that suggests healthy or normal characteristics, not sepsis. Wakefulness is a sign of alertness and responsiveness in newborns, which reflects their neurological development and adaptation. Ruddy appearance is a reddish color of the skin that is normal in newborns, especially in term or post-term infants, which indicates adequate oxygenation and hemoglobin levels.
Choice D Reason: Temperature instability and lethargy. This is because temperature instability and lethargy are common signs of sepsis in newborns, which indicate systemic infection and inflammation. Sepsis is a life-threatening condition where the body's response to infection causes tissue damage, organ failure, or death. Sepsis can occur in newborns due to maternal, fetal, or neonatal factors, such as chorioamnionitis, premature rupture of membranes, prolonged labor, invasive procedures, or bacterial colonization.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: "If I go too long overdue, the amniotic fluid volume can become too low for my baby to be safe." This is a correct answer that indicates that the client understands one of the Reasons for induction of labor at 42 weeks' pregnancy.
Choice B Reason: "My baby took longer to grow, and now she's ready to be born." This is an incorrect answer that shows a misconception about fetal growth and development. Fetal growth does not depend on gestational age alone, but also on genetic, maternal, placental, and environmental factors. A post-term fetus does not necessarily grow faster or larger than a term fetus. In fact, some post-term fetuses may experience intrauterine growth restriction (IUGR), which means slower than expected growth for gestational age.
Choice C Reason: "I don't really need this induction, my baby will come whenever he wants to." This is an incorrect answer that reveals a lack of awareness or acceptance of the need for induction of labor at 42 weeks' pregnancy. Induction of labor is recommended for post-term pregnancies to prevent potential complications such as fetal distress, stillbirth, or maternal hemorrhage.
Choice D Reason: "Since I am so tired of being pregnant, I am being induced." This is an incorrect answer that implies that induction of labor is based on maternal preference or convenience rather than medical indication. Induction of labor should not be done without a valid Reason or informed consent, as it carries some risks such as failed induction, prolonged labor, infection, uterine rupture, or cesarean delivery.
Correct Answer is C
Explanation
Choice A Reason: IgG. This is an incorrect answer that refers to a different type of antibody that is not abundant in breast milk. IgG is a type of antibody that provides systemic immunity against various antigens. IgG is found in low concentrations in breast milk, as it does not cross the mammary epithelium easily. IgG can protect the infant from some infections, but it is mainly transferred from the mother to the fetus through the placenta during pregnancy.
Choice B Reason: IgE. This is an incorrect answer that refers to a different type of antibody that is not relevant to breast milk. IgE is a type of antibody that mediates allergic reactions and parasitic infections. IgE is found in very low concentrations in breast milk, as it does not have a significant role in mucosal immunity. IgE can trigger mast cells and basophils to release histamine and other inflammatory mediators, which can cause symptoms such as itching, swelling, or bronchoconstriction.
Choice C Reason: IgA. This is because IgA is a type of antibody that protects mucosal surfaces from pathogens and toxins. IgA is found in high concentrations in breast milk, especially in colostrum (the first milk produced after delivery). IgA can bind to bacteria and viruses in the infant's gastrointestinal tract and prevent them from ataching to the intestinal wall or crossing into the bloodstream. IgA can also enhance the infant's immune system by stimulating lymphoid tissue development and modulating inflammatory responses.
Choice D Reason: IgM. This is an incorrect answer that refers to a different type of antibody that is not abundant in breast milk. IgM is a type of antibody that activates complement system and agglutinates antigens. IgM is found in low concentrations in breast milk, as it does not cross the mammary epithelium easily due to its large size. IgM can protect the infant from some infections, but it is mainly produced by the infant's own immune system in response to exposure to antigens.
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